Health effects of Menstruation

Because of fluctuations in hormone levels during the menstrual cycle, there may be various physical changes in most of the women.

Updated: November 2, 2017

Because of fluctuations in hormone levels during the menstrual cycle, there may be various physical changes in most of the women. This includes muscle contractions of the uterus (menstrual cramping) that can precede or accompany menstruation. Water retention, changes in sex drive, fatigue, breast tenderness, or nausea may be there in few cases. Breast swelling and discomfort may be caused by water retention during menstruation.
A healthy diet, reduced consumption of salt, caffeine and alcohol, and regular exercise may be effective for women in controlling some symptoms.

Cramps:

Painful cramps, also known as dysmenorrhea is experienced by many women during menstruation. Pain results from ischemia and muscle contractions. When spiral arteries in the secretory endometrium constrict, the uterine lining slough off. The myometrium contracts spasmodically in order to push the menstrual fluid through the cervix and out of the vagina. The contractions are mediated by a release of prostaglandins.
Dysmenorrhea can be primary or secondary.
When excess of prostaglandin release results in painful menstrual cramps that is known as primary dysmenorrhea.  Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives can be used for the treatment.  NSAIDs prevent prostaglandin production. With long-term treatment, hormonal birth control reduces the amount of uterine fluid/tissue expelled from the uterus resulting in shorter, less painful menstruation.
Risk factors for primary dysmenorrhea include: early age at menarche, long or heavy menstrual periods, smoking, and a family history of dysmenorrhea. Regular physical activity may limit the severity of uterine cramps.
When menstruation pain is a secondary cause to another disorder such as endometriosis, uterine fibroids, and uterine adenomyosis is called as secondary dysmenorrhea.
Congenital malformations, intrauterine devices, certain cancers, and pelvic infections can also be a cause of secondary dysmenorrhea. Symptoms include pain spreading to hips, lower back and thighs, nausea, and frequent diarrhea or constipation. If the pain lasts longer than the first few days of the period, or does not get relieved by the use of non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, women should be evaluated for secondary causes of dysmenorrhea.
When severe pelvic pain and bleeding suddenly occur or worsen during a cycle, the woman should be evaluated for ectopic pregnancy as it may be life threatening.

Bleeding:

Menstrual fluid contains some blood, as well as cervical mucus, vaginal secretions, and endometrial tissue. Menstrual fluid is reddish-brown, a slightly darker color than venous blood. Menstrual fluid is harmless and no toxins are released in menstrual flow. About half of menstrual fluid is blood and this blood contains sodium, calcium, phosphate, iron, and chloride, the extent of which depends on the woman. Vaginal fluids in menses mainly contribute water, common electrolytes, organ moieties, and at least 14 proteins, including glycoproteins.
Blood clots during menstruation that appear as clumps of blood may look like tissue which can  be confirmed by examination under a microscope if it was endometrial tissue or pregnancy tissue. The amount of iron lost in menstrual fluid is relatively small for most women. However, heavy menstrual bleeding, occurring monthly, can result in anemia.

Mood and behavior:

Starting one or two weeks before the period, some women experience emotional disturbances which stops soon after the period has started. Symptoms may include mental tension, irritability, mood swings, problems with concentration and memory. There may also be depression or anxiety. Extreme psychological stress can also result in periods stopping.

Menstrual disorders:

There are several ways that someone's menstrual cycle can differ from the normal. The underlying cause should be identified and treated accordingly. These may include:
  • Infrequent periods
  • Short or extremely light periods
  • Too frequent periods ,defined as more frequently than every 21 days
  • Extremely heavy or long periods, for example soaking a sanitary napkin or tampon every hour or so, or menstruating for longer than 7 days
  • Extremely painful periods
  • Breakthrough bleeding also called spotting between periods which is normal in many females
  • Absent periods
  • Dysfunctional uterine bleeding is a hormonally caused bleeding abnormality which occurs in premenopausal women who do not ovulate normally. 
 All these bleeding abnormalities need medical attention. They may indicate hormone imbalances, uterine fibroids, or other health problems.

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